Advanced Diagnostics, LLC (ADx) is a small business that owns, manufacturers and markets the EyeTel DigiScope Telemedicine Retinal Imaging System. This system was specifically designed to detect DR in the primary care physician (PCP) arena for patients with diabetes who are not under the routine care of an eye specialist. The DigiScope System is the only highly automated and low cost fundus camera specifically designed to assess for DR in the primary care environment. It features a validated robust telemedicine platform with sophisticated, quality control oversight and expert evaluation. This technology has the potential to increase the awareness of PCPs and their patients of the significant risks of DR while advancing patient access and compliance with recommended annual eye examinations. To date, nearly 100,000 patients with diabetes have been imaged with this system which has been utilized by almost 500 PCP practices. Specifically, our Phase 1 Research and Development Aims are targeted to deliver the following: 1. New Service Delivery Model, Tools and Advancements Applied to an Existing DR Detection Platform An innovative Service Delivery Model will be developed to bring all services, patient scheduling tools, instrumentation, reading center advancements and referral system directly to the PCP to streamline the care pathway from scheduling to evaluation to referral for treatment when necessary. 2. Educational Outreach via Direct Clinical Tools A most effective means for addressing the required awareness of the vision-threatening consequences of DR is through direct clinical education to PCPs (emphasizing "why and how") and from PCPs to patients ("why, when, and how"). Innovative educational tools will be developed and deployed through a physician awareness campaign, patient awareness campaign and patient reporting materials all incorporated with the DR system. 3. Health Care Quality Measurement and Care Improvements To establish a long standing mindset towards the need for annual dilated eye evaluations and elevate the comprehensive care of all patients with diabetes, a system and tools will be developed to advance the tracking and reporting of national health care quality measurements. 4. Delivery of Care to Uninsured Patients A method to provide DR awareness tools and the delivery of "free care" to uninsured patients will be developed and evaluated to address the critical needs of the underserved using our low-cost system. Through our DR awareness community outreach and free community care sites, we look to evaluate the care improvements and cost effectiveness of providing DR screening services for uninsured patients in community health centers. ADx has the required expertise and technology to elevate DR assessment services to a new level with increased education and awareness and the potential of providing these services to all appropriate patients. PUBLIC HEALTH RELEVANCE: The EyeTel DigiScope system was specifically designed to detect Diabetic Retinopathy in the primary care physician (PCP) arena for patients with diabetes who are not under the routine care of an eye specialist. The DigiScope System is the only highly automated and low cost fundus camera specifically designed to assess for DR in the primary care environment. This technology has the potential to increase the awareness of PCPs and their patients of the significant risks of DR while advancing patient access and compliance with recommended annual eye examinations.